Request FREE Screening

Screenings are available to children ages 2 -6 years. The screening will be completed by a certified Speech Language Pathologist and will take 20-30 minutes. The screening is not intended to report any specific diagnosis and no formal testing will be performed. You will be given information about your child’s current communication skills and any recommendations for next steps. Please fill out the form below and we will contact you to schedule a screening.

Parent Information
Name*
Address*
City*
State*
Zip*
Email*
Phone*
Relationship to Student*
How did you hear about us?*
- Word of mouth
- School Website
- Online Search
- Current or former school families: ___________
- Doctor/Therapist Recommendation: _________
- Other (please specify): ______________________
Child Information
Child Name*
Child Age*
Referral Information
BRIEFLY DESCRIBE YOUR CONCERN
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Parent Information

Child Information

Referral Information

Winter Break

Classes Resume

Parent Information

Child Information

Referral Information

CSA Parents